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目的 评价肝细胞癌肿瘤坏死与经动脉化疗栓塞 (TACE)方法的关系。材料与方法 观察 117例手术切除的肝细胞癌肿块坏死和增长率 ,其中单纯手术 5 8例 ,4种TACE后Ⅱ期手术切除 5 9例。结果 肝细胞癌TACE后坏死较自发坏死严重、范围广(P <0 .0 1) ,坏死程度和肿块体积变化与TACE方法密切相关 (多材料联合栓塞较单材料栓塞、单纯化疗改变明显 ,P <0 .0 1) ,但与TACE和手术切除间期无显著相关 (P >0 .0 5 ) ,坏死程度和体积变化显著相关 (P <0 .0 1) ,多次TACE较单次易引起肿瘤坏死 ,但无统计学意义。本组完全坏死率 2 0 .3 % ,仅见于多材料联合栓塞组。结论 多次、多材料联合栓塞TACE较单次、单材料栓塞、单纯化疗更易引起肝细胞癌坏死及肿块体积缩小 ,有效的TACE早期 ( <1个月 )即可引起肿块广泛坏死。
Objective To evaluate the relationship between hepatocellular carcinoma tumor necrosis and transcatheter arterial chemoembolization (TACE) methods. Materials and Methods Observed 117 cases of necrosis and growth rate of surgical resection of hepatocellular carcinoma mass, of which 58 cases were treated with surgery alone, and 4 cases of TACE were performed after stage II surgical resection. Results The necrosis of hepatocellular carcinoma after TACE was more severe than that of spontaneous necrosis (P < 0.01), and the degree of necrosis and volume change were closely related to the TACE method. Multi-material combined embolization was significantly more effective than single-material embolization and chemotherapy alone. <0. 0 1), but not significantly correlated with TACE and surgical resection (P > 0.05), and the degree of necrosis was significantly associated with volume change (P < 0.01). Multiple TACE was more likely than single resection. Caused tumor necrosis, but not statistically significant. The complete necrosis rate in this group was 20.3%. It was only found in the multi-material combined embolization group. Conclusion Multiple and multi-material embolization TACE is more likely to cause hepatocellular carcinoma necrosis and tumor volume reduction than single, single-material embolization and chemotherapy alone. Effective early TACE (<1 month) can cause extensive necrosis of the tumor.